DESCRIPTION
Escitalopram is an
orally administered Selective Serotonin Reuptake Inhibitor (SSRI).
Escitalopram is the
pure S-enantiomer of the recemic bicyclic phthalane derivative citalopram. Escitalopram
is at least 100 fold more potent than the R-enantiomar with respect to
inhibition of 5-HT reuptake and inhibition of 5-HT neuronal firing rate.
Escitalopram has no or very low affinity for Serotonergic (5-HT1-7) or other
receptors including alpha and beta-adrenergic, Dopamine (D1-5), Histamine
(H1-3), Muscarinic (M1-5) and Benzodiazepine receptors.
INDICATION
Escitalopram is
indicated for the treatment of major depressive disorder and maintenance therapy
to prevent people with depression from suffering a relapse. A major depressive
episode implies a prominent and relatively persistent (nearly every day for at
least 2 weeks) depressed or dysphoric mood that usually interferes with daily
functioning, and includes at least five of the following nine symptoms:
depressed mood, loss of interest in usual activities, significant change in
weight and/or appetite, insomnia or hypersomnia, psychomotor retardation or
agitation, increased fatigue, feelings of guilt or
worthlessness, slowed thinking or impaired concentration, a suicide attempt or
suicidal ideation.
DOSAGE
AND ADMINISTRATION
Treatment
Of Major Depressive illness, Generalized anxiety disorder &
Obsessive-compulsive disorder : Adolescent, Adult
over 18 years: 10 mg once daily increased if necessary to max. 20 mg daily; elderly:
initially
half adult dose, lower
maintenance dose may be sufficient; children: not recommended.
Panic
disorder :
Adult
over 18 years: initially 5 mg once daily increased to 10 mg daily after 7 days; max.
20 mg daily;
elderly: initially half adult
dose, lower maintenance dose may be sufficient.
Social
anxiety disorder :
Adult
over 18 years: initially 10 mg once daily adjusted after 2-4 weeks; usual dose 5-20
mg daily.
CONTRAINDICATION
AND PRECAUTION
Escitalopram should
not be used if the patient enters a manic phase, hypersensitive to escitalopram
and any excipients of the
product. The patient is taking monoamine oxidase inhibitor (MAOI), reversible MAOI (RIMA) and
moclobemide Escitalopram should not be used.
SIDE
EFFECT
The following
additional adverse reactions have been reported: agitation or restlessness,
blurred vision, diarrhea, indigestion,
nausea, increased or decreased appetite, increased sweating, sexual
difficulties(decreased sexual
ability or desire, ejaculatory delay), taste alterations, tremor (shaking),
weight changes.
USE IN
PREGNANCY AND LACTATION
Pregnancy category C.
The safety of Escitalopram during pregnancy and lactation has not been
established.
Therefore, Escitalopram should not be used during pregnancy, unless, in the
opinion of the physician, the
expected benefits to the patients markedly outweigh the possible hazards to the
fetus. Escitalopram is
excreted in human milk. Escitalopram should not be administered to nursing
mothers unless, in the opinion
of the treating physician, the expected benefits to the patient markedly
outweigh the possible hazards
to the child.
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